Direct clipping for the ruptured ICA bleb aneurysm; Can it be an answer?

초록

ICA blood blister like/bleb aneurysms can result in a disaster during microsurgery because they can cause the massive bleeding. Then, they require careful treatment and most surgeons reported that clipping on wrapping or segmental occlusion/ trapping followed by bypass surgery are the only optional treatment. However, its pathophysiology has not been clarified and its treatment has not yet to be clearly established. Authors have experienced 9 ICA bleb aneurysms. Seven has developed on the dorsal wall and two on the ventral wall of ICA. We treated all of them with microsurgical clipping without wrapping and there have been no complication related with surgical procedures. We performed postoperative angiography for all of them and did delayed cerebral angiography(more than 3months after operation) as well. Delayed angiography has shown that disappearance of bulbous lesion, which had always existed around ruptured teat. We are going to discuss about direct clipping as a possible alternative treatment and its pathophysiology based on the radiological findings